Doctors and nurses, including this writer, do volunteer. But the clinic patient also needs expensive blood tests, diagnostic tests, medication, and -- most of all -- continuity. Treating health care like car shopping doesn't work. You can't bargain from the back of an ambulance.

The Affordable Care Act, now implemented in Rhode Island, puts money into prevention, continuity, and health education for the public. And "federal involvement" is essential protection from multi-state corporations that engage in malpractice or create environmental hazards. You don't want to deregulate your pharmaceuticals. We've been there.

Universal health care is the model for the rest of the developed world. We are finally recognizing the human and economic cost of a fragmented and profit-based health care system. Not just the indigent, but youth and working people have found health care unaffordable.

Like Mr. Murdock, I want to see a change for the better. It is hard to wait. It is frustrating that politics and compromise are as much a factor as the physical challenges of serving millions of Americans who formerly had no access to care. But taking a giant step backward just as we begin to move forward is not the way.